A meta-analysis of individual patient data shows that the effect size of transcranial direct current stimulation (tDCS) in acute major depressive episodes is comparable with repetitive transcranial magnetic stimulation and antidepressant drug treatment.

Using a web-based guided self-help intervention lessens the incidence of major depressive disorder (MDD) relative to enhanced usual care, a recent study finds.

Suicide risk high following deliberate self-harm

06 Aug 2017

It is common for adults treated for deliberate self-harm to repeat self-injury the following year, a recent study has found.

Additionally, there is a very high risk of suicide among patients who use a violent method, specifically firearms, for their self-harm. This is particularly true right after the initial event, which emphasizes the importance of careful assessment and close follow-up of this group.

To identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm, researchers followed for up to 1 year a national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (n=61,297).

The authors determined repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years based on cause of death information from the National Death Index. Cox proportional hazard models were used to estimate hazard ratios (HRs) of repeat self-harm and suicide.

The respective rates of repeat self-harm and completed suicide were 263.2 per 1,000 person-years and 439.1 per 100,000 person-years during the 12 months after nonfatal self-harm. This is 37.2 times greater than in a matched general population cohort.

Compared with self-harm patients using nonviolent methods (HR, 7.5; 95 percent CI, 5.5 to 10.1), those using violent ones, especially firearms (HR, 15.86; 10.7 to 23.4; computed with poisoning as reference) had higher risk of suicide after initial self-harm events, and to a lesser extent after events of patients who had recently received outpatient mental healthcare (HR, 1.6; 1.2 to 2.0).

Furthermore, self-harm patients who used violent methods had significantly higher risk of suicide than those using nonviolent methods during the first 30 days after the initial event (HR, 17.5; 11.2 to 27.3), but not during the following 335 days.

Close follow-up of these patients is warranted, according to researchers.

A meta-analysis of individual patient data shows that the effect size of transcranial direct current stimulation (tDCS) in acute major depressive episodes is comparable with repetitive transcranial magnetic stimulation and antidepressant drug treatment.